February 02, 2024
Area(s) of Interest: Physician Leadership
Politicians, lobbyists and legislative staff are common sights when the California State Legislature is in session. Yet, nearly every summer for the past decade, a group you might not expect can also be found in the halls of the Capitol: students from the UC San Diego (UCSD) School of Medicine. Thanks to the “Introduction to the Politics of Medicine” class taught by Assistant Professor of Anesthesiology Robert Hertzka, M.D. – which he started in 1988 – medical students are able to step out of their usual clinical confines and gain firsthand experience working at the intersection of health care and legislation.
Below, Kiersten Gabaldon, a UCSD medical student who recently took Dr. Hertzka’s class, shared her experience and takeaways after participating in the program.
Kiersten Gabaldon (left) pictured with Assemblymember Akilah Weber, M.D..
My journey to medical school was slightly unconventional: I had varied interests in medicine, policy and business, and my background included growing up in an underserved community and working at a Big Four consulting firm. I found myself at an intriguing crossroads about what I wanted to do when I enrolled in Dr. Hertzka’s course on health policy. Under his mentorship, I was able to gain real-world experience exploring my interests.
A key component of Dr. Hertzka’s class is interning in a lawmaker’s office, and for two weeks, I was able to work closely with Assemblymember Akilah Weber, M.D., and her team representing California’s 79th Assembly District. A board-certified obstetrician/gynecologist and an educator, Dr. Weber has made strides both in the medical world as the founder of the Pediatric and Adolescent Gynecology Division at Rady Children’s Hospital-San Diego, and in the political realm as a former city councilmember. As a medical student aspiring to intertwine my future medical career with policy, learning from Assemblymember Weber was an immense privilege and a perfect fit.
The internship provided a combination of observing, learning and practical application. From examining racial biases in medical artificial intelligence (AI) algorithms to crafting vote recommendations for more than 30 bills, I found myself immersed in the policymaking landscape. Some of my hands-on tasks included drafting letters to Governor Newsom and creating Senate floor talking points for bills such as AB 1701 and AB 1138, which target racial health care disparities and bolster support for campus-based sexual assault survivors, respectively.
My internship also allowed me to attend meetings that gave me insight on policy areas outside of health care. I joined in on discussions of legislation relating to greenhouse gas emissions and LGBTQ+ legislation that sought to reinforce inclusivity and equity in educational settings, and also met with Amazon representatives to discuss equilibrium between advertising and retail under common parent companies.
One of the most interesting and insightful meetings I attended was with the Governor’s office to discuss amendments to AB 1507, Assemblymember Weber’s bill expanding flexibility for local health jurisdictions in administering home visiting programs. The discussion was rich with insights and highlighted the balance between collaboration and negotiation that is a fundamental part of the legislative process.
The AI Roundtable with legislators and the Silicon Valley Leadership AI Work Group was another highlight of my internship. I was able to engage with industry leaders from global tech giants like Google, Microsoft and Amazon, and delve deep into the potential applications and challenges of using AI in health care, as well as the need to align rapid technological advancements with ethical, moral and communal values. The roundtable reinforced my belief in the need for collaboration between policymakers and tech innovators to shape a future where AI serves humanity ethically and effectively.
Throughout the internship, the interweaving of policy and health care underscored the importance of medical students and physicians actively shaping policy. The complexity of the American health care system, with both federal and state-level regulations, makes it imperative for those who understand its nuances to have a voice in shaping its future.
Assemblymember Weber exemplifies this perfectly: two of her recent bills, AB 82 (aimed at shielding minors from the potential harm of weight loss supplements) and AB 85 (advocating for a more holistic view of health by addressing social determinants) address immediate health concerns and aim at the larger objective of preventive care and social well-being. Dr. Weber's initiatives reflect a broader vision that recognizes health outcomes as the result of complex interactions between medical care, patient choices and socioeconomic factors, and is the sort of vision that ensures we can holistically and equitably provide all Californians with high-quality care.
My experience in Dr. Hertzka’s program has undeniably influenced my path as a medical student. As I progress through medical school and eventually step into my role as a physician leader, the insights I have gained will shape my approach to patient care and advocacy. Empowered with this enriched understanding, I am more committed than ever to connecting the worlds of clinical practice and policy to effect meaningful change in health care.
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